Melanoma Awareness, Skin Cancer
Above: Early stage melanoma can take many forms – and it can grow rapidly.
Melanoma skin cancer can appear in a huge range of shapes, sizes, and colours, and can become life-threatening surprisingly quickly (sometimes in just a few months)1. Read to find out how to identify the different types of melanoma, from early stage to advanced (with images), and what melanoma looks like on different parts of the body, from head to toe.
Part I: What do different types of melanoma look like?
There are several different types of melanoma, including nodular melanoma, superficial spreading melanoma, amelanotic or ‘pink’ melanoma, lentigo maligna melanoma and acral lentiginous melanoma and each looks a little different.
What to look for: Usually, the most obvious warning signs of early stage melanoma are changes to your moles or spots: in size, shape, colour or in how they look or how they feel. Melanoma can also appear as a new mole (more commonly in people aged 50 years or more)2.
We’ve outlined the five common types of melanoma below – however, remember that melanoma is only one form of skin cancer (albeit the most dangerous). If you have a suspicious mole that doesn’t fit the criteria below, check out the other types of skin cancer.
Above: As these images show, nodular melanoma is usually raised, often symmetrical, firm to the touch and grows or changes within a few months.
1. Nodular melanoma
Nodular melanoma is one of most dangerous forms of melanoma – and accounts for about 15% of melanoma in Australia and New Zealand3.
The most worrying thing about nodular melanoma is that it can grow fast: It is malignant from the time of appearance, which is why early diagnosis and removal is so important.
What does nodular melanoma look like?
Nodular melanoma is not necessarily dark or coloured, but the key features are that it's raised, often symmetrical, firm to touch, and most importantly, is changing/growing progressively.
In the early stages, you might not notice visible signs of change – perhaps the mole is itchy, or just feels funny. This type of melanoma can affect anyone but is generally much more common in men over 50 and those with fair skin.4
Above: As you can see in these photos, superficial spreading melanoma can be irregular in shape, variable in colour, and similar to a freckle. It often appears on the legs, torso and upper back.
2. Superficial spreading melanoma
Superficial spreading melanoma is the most common form of melanoma, accounting for around 70 per cent of all cases5. It tends to grow slowly and horizontally across the top layer of skin before moving to the deeper layers. It usually occurs in the back, chest, and legs, areas that are all likely to get intense, periodic UV exposure from the sun. However, it can also appear in parts of the body that see little sun.
While can affect people of all ages, this type of melanoma occurs most often in people in their 40s and 50s. Other risk factors include having fair skin, a lot of moles, a family or personal history of skin cancer, having been sunburnt at early age, and having regular exposure to the sun or tanning beds.
How do I identify superficial spreading melanoma?
Superficial spreading melanoma sometimes looks like a freckle, which can make it hard to identify, especially in the first stages. When checking your skin, look for these early signs:
Shape: Look for an irregular shape and borders. Superficial spreading melanoma can be raised or flat and can look like a freckle that is growing at its edges.
Colour: It may be brown, tan, black, red, blue, and even white but usually has a combination of these colors.
Location: It usually appears on the torsos of men, the legs of women, and the upper backs of both sexes – even in places that do not see the sun. It can appear in an existing mole or a new mole.
Changes: The mole or spot tends to change slowly, usually over the course of several years. It can sometimes feel itchy.
You can also use the ‘ABCDE’ guidelines to help you identify the early stages of melanoma skin cancer. Early diagnosis is the key in successfully treating superficial spreading melanoma – so, if you notice any unusual spots on your skin, book a professional skin check straight away.
Above: Image 1: an amelanotic, superficial spreading melanoma on the leg/arm/back. Image 2: an example of a reddish-coloured amelanotic melanoma.
3. Amelanotic or ‘pink’ melanoma
Just to make checking your skin even more difficult, there is a relatively uncommon type of superficial spreading melanoma that has no colour at all. Known as ‘amelanotic’ or ‘pink’ melanomas, these unusual spots are missing melanin, the dark pigment that gives most moles and melanomas their colour.
Amelanotic melanoma is no more dangerous than any other form of melanoma. However, mortality rates tend to be higher than for other types of melanoma, because it often goes undetected for longer, which gives it time to spread.6
Amelanotic melanoma - what to look for?
Amelanotic or pink melanomas can be pinkish-looking, reddish, purple, normal skin colour or even clear and colourless. They may even look just like a patch of abnormal skin, making them very easy to miss when self-checking your skin. However, there are other melanoma warning signs to look for, such as an asymmetrical shape and/or an irregular border – or if a spot or mole appears suddenly, or changes shape drastically.
Sometimes, they resemble a tiny scar or acne that is healing. The biggest thing to look for is the ‘E’ for ‘evolution’ in the ABCDE guide – if you notice any changes in a mole or spot, (no matter what the colour), seek a clinical diagnosis as soon as possible.
Above: Lentigo maligna look like a flat or slightly raised brown patch, similar to a freckle or sun spot.
4. Lentigo maligna’ melanoma
Lentigo maligna melanoma is the least common type of melanoma: a type of invasive skin cancer that develops from ‘lentigo maligna’.
Lentigo maligna grows slowly and often stays on the outer surface of the skin. However, if it starts growing into the second layer of the skin it becomes the more malignant form - lentigo maligna melanoma.
What does lentigo maligna melanoma look like?
Both forms of lentigo maligna look like a flat or slightly raised brown patch, similar to a freckle or sun spot. They have a smooth surface and an irregular shape. While they are usually a shade of brown, they can also be pink, red, or white.
They are usually larger than other types of skin cancer – often being at least six millimeters wide, but can grow to several centimeters. This form of melanoma most often appears on the neck or face, especially on the nose and cheeks.
Keep an eye out for a mole with increased thickness, multiple colours (particularly black and blue), bleeding, itching or stinging – and if you have any of these symptoms, get the mole or spot checked immediately.
Above: As these photos show, acral lentiginous melanomas are usually brown or black, and occur on the palms of the hand, the soles of the feet and under fingernails or toenails. (Image references DermNet NZ)
5. Acral lentiginous melanoma
Acral lentiginous melanoma (ALM) is a type of melanoma that most commonly occurs on the palms of the hand or soles of the feet, or underneath fingernails or toenails. It can appear as a new spot, or can develop within an existing mole – often it starts as a flat, slowly-enlarging patch of discoloured skin, although it can be reddish, orange or amelanotic in colour.
This type of melanoma is usually much darker than the surrounding skin (usually brown or black) and tends to have a sharp border between the dark skin and the lighter skin around it. This contrast in colour is one of the most noticeable symptoms of this type of melanoma.
Acral lentiginous melanoma is the most common type of melanoma in people with darker skin and those of Asian descent6, although it can be seen in all skin types. It may be hard to detect in the first stages, when the patch of darkened skin is small and looks like a stain or bruise. As with all types of melanoma, early diagnosis and treatment are essential to catch this rare form of melanoma before it spreads further.
Part II: How to identify the early signs of melanoma
There are three simple guidelines that skin cancer experts recommend using to help identify the early warning signs of melanoma – the ABCDE guide, the EFG rule and the ‘ugly duckling’ rule. Keep reading for an overview of each guideline and helpful images of what to look for.
What to look for: the ‘ABCDEFG’ rules
Taught by many non-profit skin cancer authorities around the world, including the Melanoma Institute of Australia, the ABCDEFG rules are a handy guide when checking for the early signs of melanoma.
“Knowing the ABCDEFG rules is a simple step we can all take to learn to recognise the early signs of melanoma and other skin cancers" says Maria Buckingham, Clinical Manager at MoleMap, "New Zealand has the highest incidence of melanoma in the world2, which is why knowing what to look for is so crucial. On a more positive note, melanoma is almost always curable if it is detected early3 - which is why I can’t stress this enough: if you notice any suspicious warning signs, book a professional skin check as soon as possible.”
Find out more about the ABCDEFG rules of melanoma here.
If you’re concerned about a changing mole, we recommend booking with us a Skin Check as soon as possible. MoleMap’s most comprehensive service, it includes EarlyDetect mole mapping and monitoring over time to spot any changes in your moles early, when they’re most treatable.
Image: to an untrained eye, melanoma can look much like any other spot. At MoleMap, our Melanographers use 'dermatoscopes' and other high resolution imaging equipment to look deep inside a mole’s structure. For medium-to-high risk patients, our skin-mapping technology is used to track changes over time.
What does melanoma look like at different stages?
Melanoma can be difficult to spot in the early stages (especially to the untrained eye), as a malignant melanoma can sometimes look very similar to a normal mole or spot.
That’s why MoleMap uses state-of-the-art imaging technology that can view both the external and subsurface structure of any mole - seeing far more than your naked eye. This, coupled with ongoing monitoring of all at-risk moles, plus diagnosis by a specialist dermatologist, gives you the reassurance that any signs of melanoma or other skin cancers will be detected early.
In the following images, we will show you some examples of melanomas that we identified early by tracking skin changes over time.
Important disclaimer: Although the ABCDEFG rules are handy for self-checking your skin, they are not a substitute for a professional assessment using the latest technology that looks deep into moles and tracks changes over time, such as full body mole mapping.
While we always encourage regular self-checks (at least every three months), the images below show just how difficult it is to spot a melanoma versus a benign mole:
Part III: What does melanoma look like on different body parts?
So, now that you know what different types of melanomas look like, let us look specifically at what melanoma can look like on different parts of the body.
In men, melanoma is most often detected on the back and chest7, and in women, it’s most often found on the legs8. But, remember that melanoma can appear anywhere on the body, even where you least expect it - from your scalp to your torso to the soles of your feet - see 8 places you wouldn’t expect to find skin cancer.
These melanomas were all detected on different parts of the leg. In women, the legs are the most common site of melanoma.7
These melanomas were all detected on different parts of the arm – arms tend to be exposed to the sun more than other parts of the body.
As these pictures show, melanomas is fairly common on the nose – a good reason to wear a hat whenever you’re out in the sun!
All of these melanomas were detected on the back. In men, melanoma is more likely to affect the chest and back .8
Identifying moles - what’s normal?
Most moles appear when we’re children or young adults. In general, normal moles are:
Your skin is constantly changing: moles usually increase in number during childhood and adolescence, reach peak count in your 20s, then reduce with age. They can also increase in numbers with sun exposure and grow during pregnancy. If you notice a new mole that appears later in life – especially if you’re aged 50 years or older - make sure you have it professionally mapped and monitored for any further changes.
Check for changes – early and often
Here at MoleMap, we thoroughly recommend checking your skin yourself at least every 3 months (depending on your skin cancer risk – take our quick quiz to check your risk level).
Using our free self-check guide (download it here) - and keeping the rules outlined above in mind – check your body from scalp to toe (or ask someone to check it for you). You may also find this article helpful on the early warning signs of melanoma.
And remember, no matter what your age or risk level - if you notice any changes in the size, shape, colour or texture of a mole or spot, book a Full Body MoleMap straight away. Because the sooner melanoma can be detected, the more treatable – and beatable – it is.
Spot the difference answer: the mole in the centre was diagnosed as melanoma – see how the edges are a bit ragged. References: National Cancer Institute: https://www.cancer.gov/types/skin/melanoma-photos 2. Skin.cancer.org: https://www.skincancer.org/risk-factors/skin-type/ 3. Melanoma Institute Australia: https://www.melanoma.org.au/understanding-melanoma/melanoma-facts-and-statistics 4. Melanoma Institute Australia: https://www.melanoma.org.au/understanding-melanoma/what-is-melanoma 5. Healthline: https://www.healthline.com/health/superficial-spreading-melanoma#causes-and-risk-factors 6. Skincancer.org: https://www.skincancer.org/skin-cancer-information/skin-cancer-skin-of-color/ 7,8. Medical News Today: https://www.medicalnewstoday.com/articles/154322#stages
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